PLANO (CBSDFW.COM) – Experts are warning people that a common childhood complaint could actually be an outcry in disguise.

“She had been in the ER several times in the past year for abdominal pain,” recalls Dr. Martha Grimm, an emergency room physician in Plano. “She had been seen by pediatrician, they kept saying maybe it’s constipation.”

It wasn’t. Acting on instinct, Dr. Grimm added screenings for sexually transmitted diseases to the routine urine analysis. And her patient with the repeat ‘tummy ache’ tested positive.

“I didn’t want to be right,” added Dr. Grimm. “She was five.” The girl’s stepfather was abusing the little girl.

Of course, sometimes a stomach ache is just that. But, Dr. Grimm said she wants other medical professionals and caring adults to listen to that nagging voice if there’s reason to believe that it is more.

“How many more kids are we missing? How many times is ‘my tummy hurts’ really, ‘I want help’, or ‘I’m trying to tell people that something’s going on’.”

Dr. Grimm is also on the board of the Collin County Children’s Advocacy Center where experts say it is often a challenge to convince the community that abuse is not limited to certain zip codes.

“Child abuse touches every part of our community, the richest of the rich, the poorest of the poor,” said the advocacy center’s Senior Vice President and Clinical Director, Dan Powers.

“Collin County is not immune to abuse. Where there are children, there will be abuse.”

Powers said it is critical for everyone who cares for children to be watching for changes in behavior, or something that simply doesn’t look or feel right. “That’s the importance of schools—teachers, nurses, counselors,” says Powers, “because, unfortunately, it’s often a parent that’s hurting the child.”

Kandace Morgan is a school nurse in Frisco. Over her decades spent caring for children, she says she has had to make that difficult call when abuse is suspected. But, knows it is done to help the child.

“If there are unexplained bruises, or a teacher is noticing they’re more fearful about going home, we as a team on our campuses collaborate together and may get our counselor involved,” says Morgan. “We work together to see if we need to report.”

But, there are new questions now about whether the state agency tasked with protecting children is responding as required.

According to figures Child Protective Services released today and analyzed by the Texas Tribune, nearly a thousand children deemed “highest priority”—those at immediate risk of physical or sexual abuse during the past six months– were not checked on even once by investigators.

Meanwhile, for those tasked with spotting the abuse, experts say trust your instinct. It was a lesson that Dr. Grimm learned from a five-year-old girl, trying to be heard.